title: Modified LigaSure hemorrhoidectomy for the treatment of hemorrhoidal crisis.
abstract: OBJECTIVE
  This study aimed at reporting a modified LigaSure technique for the treatment of acute hemorrhoidal crisis.
  
  
  METHODS
  Consecutive patients with an acute hemorrhoidal crisis received a modified LigaSure hemorrhoidectomy. After removing the hemorrhoidal tissues above the welding line, scissors were used to undermine the anoderm to excise residual thrombosed hemorrhoidal tissue. The wound was approximated with a continuous 4-0 vicryl suture.
  
  
  RESULTS
  Forty patients (mean age, 47.5 years; range 22.0-76.0 years) were included. The mean duration of the crisis, length of the operation, and follow-up were 2.0 days (range 1.0-5.0 days), 35.6 min (range 15.0-60.0 min), and 13.2 months (range 6-24 months), respectively. At the final follow-up, all patients were continent and there were no cases with anal stenosis, recurrent bleeding, prolapse, or thrombus. The mean pain score before surgery was 8.3, and was 4.4 and 3.2 on postoperative days 1 and 7, respectively. Complications within 30 days of surgery included two cases of urine retention, two cases bleeding, one wound infection and one case of fecal impaction, which all resolved with conservative treatment. The only late complication was one case of residual skin tags.
  
  
  CONCLUSIONS
  The modified LigaSure hemorrhoidectomy offers rapid pain relief, early recovery, and low morbidity for patients with an acute hemorrhoidal crisis.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, No. 289, Jianguo Rd., Sindian, New Taipei City, 23142, Taiwan, ROC.
authors.forename: Chuang-Wei
authors.initials: CW
authors.lastname: Chen
authors.forename: Chieh-Wen
authors.initials: CW
authors.lastname: Lai
authors.forename: Yao-Jen
authors.initials: YJ
authors.lastname: Chang
authors.forename: Koung-Hong
authors.initials: KH
authors.lastname: Hsiao
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D061865:Hemorrhoidectomy / Q000379:methods*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011182:Postoperative Care; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult